In a patient with acute limb ischemia, what initial therapy is recommended while waiting for surgical evaluation?

In cases of acute limb ischemia, the initial therapy focuses on managing the condition effectively while awaiting surgical intervention. The recommended option focuses on anticoagulation to optimize blood flow and minimize the risk of further thrombus formation in the affected limb.

Unfractionated heparin (UFH) plays a crucial role in this setting. The initial bolus of 80 units/kg rapidly achieves therapeutic anticoagulation, while the continuous infusion at 18 units/kg/hour maintains this effect. This approach helps prevent further clot propagation and potentially restores perfusion to the ischemic limb.

The use of UFH is especially important for acute limb ischemia, as it is readily reversible, has a short half-life, and allows for quick adjustments based on a patient's response or laboratory monitoring. Other options do not provide the same immediate and effective anticoagulation necessary for acute situations and may not be suitable for the urgency of limb viability in this context.